More relevant now than ever: a review of Carriers by Patrick Lynch

Indonesia: you are leading a team through the hot zone, in every sense, of a new epidemic. You are looking all around you for the source but cannot find it. Where do you look next?

Carriers is a medical thriller about the hunt for a novel filovirus, ie a highly contagious micro-organism whose victims often die by bleeding out. It was published in 1995, on the heels of Richard Preston's The Hot Zone, which deals with the real-life search for the world's most famous filovirus, Ebola. Like its fictional relative in Carriers, Ebola is a haemorrhagic virus which, following an incubation period lasting anything from a few days to two or three weeks, enters its terrifying final phase.Eextreme bleeding, internal and external, conspires with diarrhoea and vomiting to provide the coup de grâce for the victim and a death sentence for most in the vicinity.

Performing the good offices of a Michael Crichton, Lynch uses a rattling good story that hums with tension as the USAMRIID (US Army Medical Research Institute of Infectious Diseases) ventures ever deeper into their own heart of darkness as international political pressures mount on the Indonesian government to Get Something Done. 

In an homage to Peston, Lynch has the stateside outbreak spread by monkeys used for medical research. In The Hot Zone, Preston makes a solid case for Ebola having jumped to humans from laboratory monkeys, the virus having perfected its cross-species athletics while monkeys were stored together. He also follows Peston in his team considering bats as a source of the contagion they hunt. COVID-19 anybody? We may never know if that particular pandemic originated in a laboratory, but Lynch has undertaken extensive research of his own to demonstrate how containment measures in even the most highly graded biosafety facilities can never exclude the risk of a virus leak, but can only reduce the probability.

Lynch probably wanted to keep his focus on the issue of one type of virus for reasons of dramatic tension, which he maintains masterfully. It's interesting, however, that Preston takes a diversion, both mtaphorically and literally, up the so-called AIDS Highway - which in reality was never a single thoroughfare but consists of several roads -  where the spread of HIV was blamed on prostitutes servicing the truck-drivers crossing the Democratic Republic of the Congo. Refusing to passively accept the myth of HIV's initial dissemination, Lynch followed the unfairly notorious itinerary to its terminus at Uganda's Lake Victoria, and found that since the mid-1960s trucks had carried payloads of monkeys taken from the Lake's islands. Is it possible that vivisectionists, in their ignorance, inflicted the wages of their sins upon the world just by incentivising monkey traders in Uganda and the DRC to maximise their profits? 

So - returning to topic - what is the source of the virus in Carriers? 

For his denouement, Lynch goes beyond the pages of The Hot Zone to displey his genius in telling a story that is based all too firmly on science that is so infrequently mined by popular science outlets as to remain cutting-edge to the lay reader now. If you want a medical thriller that, if anything, bites even more trenchantly now than when it was published, read Patrick Lynch's Carriers. 

Quickly, before the next pandemic starts.